The Portfolio Committee on Health met on Tuesday and received presentations from various entities that report to the Department of Health, providing an in-depth look at their strategic plans, annual performance and key challenges.
The Financial and Fiscal Commission (FFC) began by offering an analysis of the performance and budget allocations of the Department of Health and its entities. The FFC highlighted the significant disparities in the South African health sector, which is characterised by a "two-tier system" where the high-cost private sector serves a small portion of the population, while the public sector faces input cost pressures and exceptional demand.
One of the key recommendations from the FFC was the need for the development and implementation of a single electronic system that includes live health record information. A committee member, Dr Karl le Roux, emphasised the importance of this recommendation, stating, "This, the commission argued, would be crucial for professionalising the National Health Insurance (NHI) and informing healthcare financing and provisioning decisions."
The FFC also urged the Minister of Health to prioritise maintaining and improving the quality of healthcare in existing public hospital systems through the reprioritisation of resources and funds to achieve allocative efficiency. Additionally, the commission recommended that the Minister, together with provincial departments of health, strengthen accountability mechanisms in public hospitals and provide guidelines to improve management practices and enhance transparency.
Next, the committee heard from the Mines and Works Compensation Fund (MWCF), which is responsible for providing compensation services for current and ex-mine workers. The presentation highlighted the significant progress made by the MWCF in recent years, including the achievement of unqualified audits since 2021/22 and the growth of the fund from R2.8 billion to R5.9 billion.
One of the key challenges facing the MWCF is the issue of unpaid claims, with approximately 75 000 claims valued at R1.3 billion still outstanding. The fund has been working to address this through a combination of data exchange, physical outreach activities, and a call centre support system. However, committee members expressed concerns about the pace of these efforts and the need for a more comprehensive and expedited solution to ensure that all eligible mine workers and their families receive the compensation they are due.
The Office of Health Standards Compliance (OHSC) also presented its strategic plan and annual performance targets, which include progressively scaling up inspections, implementing enforcement actions and enhancing public trust in the safety and quality of healthcare services. The committee members raised concerns about the OHSC's current inspection coverage, which stands at only 29% of health establishments, and the potential impact on the implementation of the NHI.
In response, the OHSC representatives acknowledged the challenges and outlined plans to introduce "smart inspections" and a self-assessment system to ramp up the inspection process. They also highlighted the ongoing discussions with the NHI unit to explore ways of ensuring that health establishments can be conditionally accredited while the OHSC continues its inspection and certification work.
The South African Medical Research Council (SAMRC) presentation focused on the organisation's strategic priorities, which include addressing the significant funding challenges facing the health research sector, promoting indigenous knowledge systems and African traditional medicine, and driving transformation within the organisation.
The SAMRC highlighted the "existential crisis" caused by the unprecedented withdrawal of funding from the United States, which has historically been a major source of support for health research in the country. To mitigate the impact of these funding cuts, the SAMRC indicated that it is leading a coordinated effort to raise funds from a variety of sources, including the South African government, local philanthropy and the corporate sector.
The committee members asked questions about the SAMRC's efforts to support historically disadvantaged institutions and ensure equitable access to research funding. The SAMRC acknowledged the challenges in this area and committed to exploring ways to leverage funding from sources such as the Sector Education and Training Authorities to support capacity development and training of young scientists.
Yoliswa Landu
24 April 2025
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